Broker License & Appointment Paperwork | Kaiser Permanente

Are you a licensed broker looking to get appointed with Kaiser Permanente? We have options!

Request a new appointment

Option 1: Ask our Broker Support team to send you all the documents you need to complete via AdobeSign.
Steps:

      o   What type of appointment you are seeking – agency, agent or both
      o   Name of Agency or Agent or Both
      o   Email Address where our team can send the AdobeSign paperwork

  • You can expect to receive your AdobeSign email within 2 business days
  • Appointment paperwork is typically processed within 10 business days of receipt of completed documentation

Option 2: Email your appointment documentation directly.
Steps:

  • Download and complete these documents which contain the following elements:

- Contact Sheet for Agency and Agent Details
- Completed IRS Form W-9
- Signed Broker Agreement
- Copy of Valid Health Insurance License for each state appointment is requested (VA, DC, and/or MD)
- Copy of Errors and Omission Proof of Insurance highlighting coverage amounts
- Copy of FFM (Federally Facilitated Marketplace) Certificate

  • Scan and email all of your documentation to BrokerSupport-MAS@kp.org and specify what type of appointment you are seeking – agency, agent or both
  • Electronic signatures are not accepted.
  • Appointment paperwork is typically processed within 10 business days of receipt of completed documentation